新疆汉、维民族糖调节受损人群胰岛素分泌功能和胰岛素作用功能的研究

Study on insulin secretion and action in Xinjiang Han and Uygur subjects with impaired fasting glucose and impaired glucose tolerance

目的评估新疆汉、维民族在IFG、IGT及IGR阶段胰岛素分泌功能和作用。方法采用多中心研究进行横断面调查,行OGTT。用胰岛素抵抗指数(HOMA-IR)评估IR,胰岛β细胞功能指数(HOMA-β)评估基础胰岛素分泌;ΔI30/ΔG30评价胰岛素早相分泌;ΔI30/ΔG30/HOMA-IR评估葡萄糖处置指数(DI)。结果 WC、BMI、血脂、FIns、2hIns在汉、维民族不同糖代谢组比较,差异有统计学意义。与NGT、IGT组比较,IFG组汉、维族人群HOMA-IR差异有统计学意义。汉族NGT组与IGT、IGR组比较,HOMA-β差异有统计学意义(P=0.030、0.044),维族IFG组与NGT组比较差异有统计学意义(P=0.001)。ΔI30/ΔG30、DI在两民族不同糖代谢组差异均无统计学意义。结论汉族人群IR在IFG阶段,胰岛素分泌功能在IGT阶段起主要作用。IR和胰岛素分泌功能在维族人群IFG阶段起重要作用。胰岛素早相分泌及葡萄糖处置功能在IGR阶段作用不显著。

Objective To evaluate insulin secretion and action in XinJiang Han and Uygur subjects with impaired fasting glucose （IFG） , impaired glucose tolerance （IGT） and impaired glucose regulation （IGR）. Methods A multicenter cross-section survey was conducted and all subjects underwent an oral glucose test （OGTT）. Homeostasis model assessment of insulin resistance （HOMA-IR） and βcell function （HOMA-β） were calculated. The ratio ofΔI30/ΔG30 was used to evaluate the early phase insulin secretion . ΔI30/ΔG30/HOMA-IR was used to evaluate the glucose disposition index （DI）. Results There were significant difference in WC, BMI, lipids ,0 and 120 min insulin level among different glucose tolerance status in Han versus Uygur subjects.）,Compared with NGT and IGT, IFG group showed significantly different HOMA-IR between Han and Uygur subjects. In Han subjects, HOMA-β was significantly different （P=0.030,P=0.044）in comparison of NGT with IGT or IGR, but in IFG versus NGT in Uygur showed significantly different in HOMA-β（P=0.001）.The significant differences in ΔI30/ΔG30 and DI were not found in both minorities and among NGT,IFG,IGR and IGT . Conclusion In Han, insulin resistance in IFG as well as insulin secretion in IGT plays an important role. Both insulin resistance and declined insulin secretion are contributing to the onset of IFG in Uygur. Both I30/ΔG30 and DI have no significant role in impaired fasting glucose and impaired glucose tolerance in both ethnics.